Healthcare Provider Details

I. General information

NPI: 1104741222
Provider Name (Legal Business Name): EVERLIN FERNANDEZ NP IN PSYCIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 MADISON AVE STE 15265
NEW YORK NY
10016-5101
US

IV. Provider business mailing address

169 MADISON AVE STE 15265
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 917-625-5395
  • Fax:
Mailing address:
  • Phone: 917-625-5395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. EVERLIN ELIZABETH FERNANDEZ
Title or Position: PSYCHIATRIST
Credential: NP
Phone: 646-836-3046